Exercise interventions through cardiac fitness programmes improve aerobic capacity and quality of life in paediatric patients with heart disease. The aim of this study was to characterise the landscape of paediatric cardiac fitness programmes via the Global Coalition for Fitness and Congenital Heart Disease (GloCo), an international network of experts providing exercise-based interventions for children and young adults with congenital and acquired heart disease. A survey was developed and distributed electronically to GloCo members and was completed by 40/53 individuals (response rate 75%), including 23 centres in 6 countries, predominantly US based. Programmes were similar with regard to duration, session frequency, and eligible patient populations but varied with regard to mode of delivery, equipment, incentives, funding sources, and cost. At the time of completion, 14 (61%) centres had enrolled at least 1 patient, and 4 (17%) centres were developing programmes. Respondents felt that cardiac fitness programmes are effective at improving quality of life/wellness (87%), cardiovascular fitness parameters (67%), and neuromuscular strength (47%) and that the most important outcomes were quality of life/wellness, exercise testing parameters, and strength/flexibility assessments. Paediatric cardiac fitness programmes focusing on exercise interventions represent a growing international field with diverse applications. Significant variability in their structure and implementation creates barriers to developing consensus guidelines and achieving standardised care. This study underscores this variability and the need for increased collaboration across centres. Multicentre research is essential to determining the optimal design of these programmes, which in turn will allow for the development of comprehensive, evidence-based guidelines.

Better understanding is needed regarding the effects of exercise alone, without any imposed dietary regimens, as a single tool for body-weight regulation. Thus, we evaluated the effects of an 8-week increase in activity energy expenditure (AEE) on ad libitum energy intake (EI), body mass and composition in healthy participants with baseline physical activity levels (PAL) in line with international recommendations. Forty-six male adults (BMI = 19·7–29·3 kg/m2) participated in an intervention group, and ten (BMI = 21·0–28·4 kg/m2) in a control group. Anthropometric measures, cardiorespiratory fitness, EI, AEE and exercise intensity were recorded at baseline and during the 1st, 5th and 8th intervention weeks, and movement was recorded throughout. Body composition was measured at the beginning and at the end of the study, and resting energy expenditure was measured after the study. The intervention group increased PAL from 1·74 (se 0·03) to 1·93 (se 0·03) (P < 0·0001) and cardiorespiratory fitness from 41·4 (se 0·9) to 45·7 (se 1·1) ml O2/kg per min (P = 0·001) while decreasing body mass (−1·36 (se 0·2) kg; P = 0·001) through adipose tissue mass loss (ATM) (−1·61 (se 0·2) kg; P = 0·0001) compared with baseline. The control group did not show any significant changes in activity, body mass or ATM. EI was unchanged in both groups. The results indicate that in normal-weight and overweight men, increasing PAL from 1·7 to 1·9 while keeping EI ad libitum over an 8-week period produces a prolonged negative energy balance. Replication using a longer period (and/or more intense increase in PAL) is needed to investigate if and at what body composition the increase in AEE is met by an equivalent increase in EI.

Bioimpedance spectroscopy (BIS) has been used to track changes in total body water (TBW). Accurate TBW estimations can be influenced by both methodological and biological factors. One methodological variation that contributes to BIS TBW errors is the electrode placement. The purpose of the present study was to compare the reproducibility and validity of fixed-distance electrode placements (5 cm) with the standard single-site electrode placements. Twenty-nine subjects (fifteen men and fourteen women) participated in the reproducibility study, while sixty-nine subjects (thirty-three men and thirty-six women) participated in the validity study. The reproducibility study included two measurements that were taken 24 h apart, while the validity study consisted of a 12-week exercise intervention with measurements taken at weeks 1 and 12. TBW was estimated using BIS and 2H techniques. Reproducibility results indicated that fixed-distance electrodes reduced the day-to-day standard error of the measurement in men (from 1·13 to 0·81 litres) but not in women (0·47 litres). sem values were lower for women than for men, suggesting that BIS TBW estimates are sex dependent. Validity results produced similar accurate findings (mean difference < 0·21 litres). However, fixed-distance electrodes improved delta TBW errors (mean difference improvements>0·04 litres in men, women, and men and women combined). When tracking changes in TBW, fixed-distance electrodes may reduce reproducibility errors and allow for smaller changes to be detected. However, the reduction of reproducibility errors may be greater for men than for women. Therefore, reproducibility calculations should be based on the sex of the sample population.